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Incidence, prevalence, and scale of blinding malnutrition
Insights
Xerophthalmia, a severe eye condition, affects thousands of preschool children annually in Indonesia, potentially leading to blindness. This study highlights the urgent need for interventions to prevent childhood vision loss.
Area of Science:
- Ophthalmology
- Public Health
- Nutritional Epidemiology
Background:
- Xerophthalmia remains a significant cause of preventable childhood blindness in developing nations.
- Prevalence and incidence data are crucial for understanding the burden of vitamin A deficiency-related eye disease.
Purpose of the Study:
- To determine the incidence and prevalence of active corneal xerophthalmia in preschool-aged children in Indonesia.
- To estimate the annual number of new xerophthalmia cases and their potential for causing blindness.
Main Methods:
- A longitudinal study involving 4595 children in West Java, with examinations every 3 months.
- A randomized, multistage cluster survey of 27084 rural children across Indonesia.
Main Results:
- The incidence of active corneal xerophthalmia was 5 per 1000 child-years in West Java.
- The population-weighted prevalence in Indonesia was 6.4 per 10,000 children.
- An estimated 60,000 Indonesian children develop xerophthalmia annually, with extrapolations suggesting 500,000 cases in four Asian countries.
Conclusions:
- Xerophthalmia poses a substantial public health threat to Indonesian children, with a high risk of progressing to blindness.
- Urgent, large-scale interventions are needed to combat vitamin A deficiency and prevent childhood vision impairment in the region.
Abstract:
4595 pre-school-age children in six villages of West Java were examined every 3 months. The incidence of active corneal xerophthalmia was 5 per 1000 per year (95% confidence limits, 2.6-7.5), and the average prevalence during each round of examinations was 12 per 10000. In a randomised, multistage cluster survey of 27084 rural children throughout Indonesia the population-weighted prevalence of active corneal disease among pre-school-age children was 6.4 per 10000 (95% confidence limits 3.2-9.6), 53% of that in the longitudinal study areas. At an adjusted incidence rate of 2.7 per 1000 per year, over 60000 Indonesian children become xerophthalmic every year. By extrapolation of these findings about 500000 new cases of xerophthalmia, half of which lead to blindness, occur each year in India, Bangladesh, the Philippines, and Indonesia combined.